NPI | 1699403097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 19921) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048967) |
Enumeration Date | 2022-08-12 |
Last Update Date | 2024-06-18 |